Imagine a world without the sweet aromas and smells that embrace our daily lives. Worse still, imagine having a horrid, bad smell lingering in the nose and being unable to find the source of it.
The reasons for the bad smell in the nose are many. We look at what a patient went through, the medical condition that causes smell disorders and what doctors from the different branches of medicine, both modern and traditional, have to say.
‘Most days I get that bad smell, but never knew where it came from,’ says a patient who suffered from a bad smell in the nose
“Eeeks, what is that smell? That lingering bad smell. I checked around, but couldn’t find the source. Is it me? People around me seem to be unaware of any smell, going about their daily chores as usual.
“Most days I get that bad smell, but never knew where it came from. I bathe at least twice a day and keep a very hygienic routine in life. So, the source of the smell remained an elusive but bothersome factor in my life.
“Some days the smell was so horrible, I couldn’t even sit at my work desk and concentrate on what I was doing. Finally, I decided to approach a doctor, an ENT specialist.
“That threw some light on my situation. I am suffering from a nose smell, it could be due to polyps in my nose, sinus issues or decaying teeth.
“After an X-Ray and an evaluation using a probe, the doctor ruled out polyps and teeth decay and concluded that my sinus is causing the bad smell.
“Neti Pot cleansing and medication finally brought me back to the normal world of smell. Finally, I am out of that bad smell in my nose. What a relief.”
An ENT specialist in Dubai explains about smell disorder
It is alright to experience a bad smell if the source of that is something external and tangible, but to feel the same in the absence of any identifiable external causes is a matter of concern, for it might point to the fact that there may be something amiss in the nose or the sinuses, or maybe even the mouth and throat, said Dr Sundarrajan Santhanam, Specialist Otolaryngologist.
More seriously there may be something wrong with the brain, which processes the smell input or the smell nerves which end up on the roof of the nose, explained Dr Sundarrajan of Mediclinic Welcare Hospital, Dubai.
Diagnosis
Unlike most other conditions we can’t use numerical values to define smell loss or altered smell as we yet don’t have a standardised clinical test freely available. Some academic centres use olfactometers and smell identification kits but it is work in progress still, said the Dubai-based ENT specialist.
“We therefore mostly rely on patients’ descriptions of his/her smell disturbance. We however can use routine sinus x-rays and nasal endoscopies in addition to a standard ENT examination to rule out the above-mentioned causes and rarely more advanced modalities like CT or MRI.”
Treatment
If the onset of the smell disorder is sudden, say after a viral infection like COVID, then there is a role for medications including, but not limited to, steroids in the form of nasal sprays or oral tablets, said Dr Sundarrajan. Supplements, especially zinc, have been proven to be of some value in smell-disturbed patients, he said.
Watch: ENT Specialist Dr Sundarrajan explains smell disorder, diagnosis, and prevention
What is Cacosmia?
Cacosmia, a smell disorder, is also a type of Parosmia. People suffering from cacosmia, describe the smell as similar to faeces, burning, rotten, or chemical odour.
The problem occurs when there is a problem in the smell pathway.
Some of the reasons for bad smell in the nose and what they are:
Nasal polyps
Nasal polyps are soft growths that are painless forming on the wall of your nasal passage or sinuses. These small noncancerous growths form due to inflammation.
Sinus infections
When the air-filled cavities in the face (sinuses) are filled with fluid, the infection starts, allowing germs to grow. It can either be a virus or a bacterial infection.
Postnasal Drip
The mucus from the nose normally mixes with saliva and we swallow it, but when there is an excess secretion it is normally thicker and runs down the back of the nose to the throat. This could also trigger a bad smell in the nose.
Tooth decay
When bacteria accumulate and chip into the surface of the tooth, decay begins and can cause a bad smell in the nose.
Tonsil stones
Crevices inside the tonsils can trap food particles and dead cells, which can slowly harden and become tonsil stones, which can also cause a nose smell.
Allergic Rhinitis
Allergic Rhinitis is a reaction to allergens in the air that triggers sneezing, congestion, itchy nose and sore throat. Pollen and other allergy-causing substances can cause the condition, which is also called Hay Fever.
How Ayurveda treats bad smell in the nose
Pootinasa is the term used by Ayurveda to denote foul or altered smell in the nose, said Dr V L Shyam, an Ayurveda Practitioner.
According to Ayurveda, the mind is the extraordinary sense organ or the king of all sense organs.
To indulge the sense organs in their respective objects is a function of the mind. Mind connects with the intellect; intellect determines the specific properties of the object of sense organs, explained Dr Shyam, Medical Director of Dr Shyam’s Ayurveda Centre in UAE.
Skewed (excessive, deficient and improper) association of senses with their objects of focus, together with the mind, leads to abnormal sensations and emotions, while proper association returns such sensations to normalcy. Stress, migraine, neurological, psychological and psychiatric issues are surely considered in Ayurveda a reason for the below-mentioned conditions:
• Increased sensitivity to smell (Hyperosmia)
• Decreased sense of smell (Hyposmia)
• Loss of smell (Anosmia)
• Distorted sense of smell (Parosmia)
Certain hemorrhagic conditions can trigger the smell of iron, fish, and blood in the nose, said Dr Shyam.
Watch: Ayurveda Practitioner Dr Shyam explains about causes and prevention of smell disorder
How Homeopathy tackles bad smell in the nose
Homoeopathy is a system of medicine where the patient is treated on symptom similarity, explained Dr Rosamma Sabu, Homeopathic Practitioner.
In cases where you cannot find out the exact cause of the bad smell in the nose and the patient presents with very particular symptoms without any physical or psychological problems, then symptom similarity is the key which helps homoeopaths treat patients successfully by considering their general nature, particular food habits, sleeping patterns, said Dr Rosamma of Balsam Homeopathic Centre, Sharjah.
Homeopathy has treatment for fifty-plus smells felt in the nose like the smell of blood, smoke, and many other smells, she said.
Watch: Homeopathic Practitioner Dr Rosamma explains the unique treatment methods
What is Unani and how it treats smell disorder?
Unani is based on the humoral theory, according to which the body comprises four different kinds of fluids (Aqlat): Dam (blood), Balgham (phlegm), Safra (yellow bile), and Sauda (black bile). Imbalances in these fluids lead to different diseases, explained Dr Syed Asaduddin Ahmed, Unani Medicine Specialist.
Other than fluids, the temperament of the person’s body is also considered. Unani identifies four different types of temperaments: hot, cold, dry and moist, said Dr Syed of Al Hijama Alternative Medical Centre, Sharjah.
Each person has a combination of temperaments: hot and dry, hot and moist, cold and dry or cold and moist. People with mostly cold temperament are much more likely to face olfactory impairments, he said.
According to Unani, there can be a total loss of smell or impairment in abilities relating to smell and the cause may be localised to the nostrils or can involve the brain, Dr Syed said.
Unani can cure bad smell and loss of smell with a combination of internal medicine such as a mixture of herbs in the form of herbal teas along with inhaling vapours of different herbs, Dr Syed explained.
Watch: Unani Medicine Specialist Dr Syed explains about causes and treatment
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